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Chan LL, Ho YY, Taylor ME, Mcveigh C, Jung S, Armstrong E, Close JC, Harvey LA. Incidence of fragility hip fracture across the Asia-pacific region: A systematic review. Arch Gerontol Geriatr 2024; 123:105422. [PMID: 38579379 DOI: 10.1016/j.archger.2024.105422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE This systematic review aimed to update fragility hip fracture incidences in the Asia Pacific, and compare rates between countries/regions. METHOD A systematic search was conducted in four electronic databases. Studies reporting data between 2010 and 2023 on the geographical incidences of hip fractures in individuals aged ≥50 were included. Exclusion criteria were studies reporting solely on high-trauma, atypical, or periprosthetic fractures. We calculated the crude incidence, age- and sex-standardised incidence, and the female-to-male ratio. The systematic review was registered with PROSPERO (CRD42020162518). RESULTS Thirty-eight studies were included across nine countries/regions (out of 41 countries/regions). The crude hip fracture incidence ranged from 89 to 341 per 100,000 people aged ≥50, with the highest observed in Australia, Taiwan, and Japan. Age- and sex-standardised rates ranged between 90 and 318 per 100,000 population and were highest in Korea and Japan. Temporal decreases in standardised rates were observed in Korea, China, and Japan. The female-to-male ratio was highest in Japan and lowest in China. CONCLUSION Fragility hip fracture incidence varied substantially within the Asia-Pacific region. This observation may reflect actual incidence differences or stem from varying research methods and healthcare recording systems. Future research should use consistent measurement approaches to enhance international comparisons and service planning.
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Affiliation(s)
- Lloyd Ly Chan
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Y Y Ho
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia; Tengku Ampuan Afzan Hospital, Jalan Tanah Putih, Kuantan, Pahang 25100, Malaysia
| | - Morag E Taylor
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Mcveigh
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sonya Jung
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Elizabeth Armstrong
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Ct Close
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia; South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Lara A Harvey
- Fall, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
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Hestnes I, Solberg LB, Meyer HE, Sundet M, Rimal R, Nordsletten L, Hakestad KA. The hip fracture incidence in the high-risk area Oslo continues to decline. Osteoporos Int 2024:10.1007/s00198-024-07156-8. [PMID: 38922398 DOI: 10.1007/s00198-024-07156-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/16/2024] [Indexed: 06/27/2024]
Abstract
Oslo in Norway has had the highest incidence of hip fractures in the world. The incidence in Oslo has been thoroughly described every decade since the late 1970s. The incidence in Oslo has previously been higher compared to the rest of Norway but has now decreased to a level below the country average. PURPOSE The purpose of this study was to report the incidence of hip fractures in Oslo in 2019 and compare it with the incidence rates from the previous four decades. METHODS Patients residing in Oslo in 2019 with a new hip fracture identified by searching the Oslo hospital's patient administrative systems and protocols from the operating theaters. The diagnosis was verified through medical records and/or radiographs. To compare with previous studies, the direct standardization method was used with the population of Oslo in 2019 as the standard. RESULTS A total of 758 hip fractures, 70% women, were identified in 2019. The age-standardized incidence rates per 10,000 person-years in 2019 (95% CI) were 45 (41.1-48.8) for women and 30 (25.8-33.8) for men. In women, there has been a continuous decline in age-standardized rates the last three decades and in men the last two decades. The most pronounced decline was seen in the oldest age groups over 70 years. There has been a secular decline in both cervical and trochanteric fractures; however, the decrease in trochanteric fractures was most distinct for males, with more than two times higher risk in 1996/1997 compared to 2019. CONCLUSION Incidence rates for hip fractures in Oslo in 2019 were the lowest rate reported since 1978. The decrease was significant for both men and women. For the first time, the incidence rates are below the national rates of Norway. However, the rates are still among the highest worldwide.
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Affiliation(s)
- I Hestnes
- Division of Orthopaedic Surgery, Oslo University Hospital, Nydalen, Postbox 4950, 0424, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - L B Solberg
- Division of Orthopaedic Surgery, Oslo University Hospital, Nydalen, Postbox 4950, 0424, Oslo, Norway
| | - H E Meyer
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - M Sundet
- Department of Orthopaedic Surgery, Diakonhjemmet Hospital, Oslo, Norway
| | - R Rimal
- Institute of Basic Medicine, Department of Biostatics, OCBE, University of Oslo, Oslo, Norway
| | - L Nordsletten
- Division of Orthopaedic Surgery, Oslo University Hospital, Nydalen, Postbox 4950, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - K A Hakestad
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Oftebro I, Skjaker SA, Fridheim HL, Frihagen F, Meyer HE, Nordsletten L, Solberg LB. Decrease in incidence of distal radius fractures in Oslo, Norway. Arch Osteoporos 2024; 19:28. [PMID: 38602605 PMCID: PMC11009733 DOI: 10.1007/s11657-024-01383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/09/2024] [Indexed: 04/12/2024]
Abstract
This study reported the incidence of validated adult distal radius fractures in Oslo, Norway, in 2019. The incidence has been reduced over the last 20 years. However, it is still high compared to other regions in Norway and some of the other Nordic countries. PURPOSE We aimed to report the incidence of distal radius fractures in Oslo in 2019 and compare it to the incidence rates in 1998/1999. METHODS Patients aged ≥ 20 years resident in Oslo sustaining a distal radius fracture in 2019 were identified by electronic diagnosis registers, patient protocols, and/or radiology registers. The diagnosis was verified using medical records and/or radiology descriptions. We used the same method as the previous study from Oslo, making the comparison over time more accurate. The age-adjusted incidence rates and the age-standardized incidence rate ratio (IRR) were calculated. RESULTS The absolute number of fractures decreased from 1490 in 1998/1999 to 1395 in 2019. The IRR for women and men in the age group ≥ 20 years in 2019 compared to 1998/1999 was 0.77 (95% CI 0.71-0.84) and 0.77 (95% CI 0.66-0.90), respectively. The IRR for women and men in the age group ≥ 50 years in 2019 compared to 1998/1999 was 0.78 (95% CI 0.71-0.86) and 0.78 (95% CI 0.63-0.97), respectively. For the population in Oslo with Asian background compared to Norwegian background in the age group ≥ 50 years, the IRR in 2019 was 0.57 (95% CI 0.40-0.80) for women and 0.77 (95% CI 0.44-1.37) for men. CONCLUSIONS The incidence of distal radius fractures in Oslo has decreased over the last 20 years. It is still, however, higher than in other areas of Norway and in some of the other Nordic countries.
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Affiliation(s)
- I Oftebro
- Department of Orthopedic Surgery, Oslo University Hospital, Nydalen, 0424, Postbox 4950, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - S A Skjaker
- Department of Orthopedic Surgery, Oslo University Hospital, Nydalen, 0424, Postbox 4950, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H L Fridheim
- Department of Orthopedic Surgery, Diakonhjemmet, Oslo, Norway
| | - F Frihagen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Orthopedic Surgery, Østfold Hospital Trust, Grålum, Norway
| | - H E Meyer
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - L Nordsletten
- Department of Orthopedic Surgery, Oslo University Hospital, Nydalen, 0424, Postbox 4950, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L B Solberg
- Department of Orthopedic Surgery, Oslo University Hospital, Nydalen, 0424, Postbox 4950, Oslo, Norway
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Harris E, Clement N, MacLullich A, Farrow L. The impact of an ageing population on future increases in hip fracture burden. Bone Joint J 2024; 106-B:62-68. [PMID: 38160690 DOI: 10.1302/0301-620x.106b1.bjj-2023-0740.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Aims Current levels of hip fracture morbidity contribute greatly to the overall burden on health and social care services. Given the anticipated ageing of the population over the coming decade, there is potential for this burden to increase further, although the exact scale of impact has not been identified in contemporary literature. We therefore set out to predict the future incidence of hip fracture and help inform appropriate service provision to maintain an adequate standard of care. Methods Historical data from the Scottish Hip Fracture Audit (2017 to 2021) were used to identify monthly incidence rates. Established time series forecasting techniques (Exponential Smoothing and Autoregressive Integrated Moving Average) were then used to predict the annual number of hip fractures from 2022 to 2029, including adjustment for predicted changes in national population demographics. Predicted differences in service-level outcomes (length of stay and discharge destination) were analyzed, including the associated financial cost of any changes. Results Between 2017 and 2021, the number of annual hip fractures increased from 6,675 to 7,797 (15%), with a rise in incidence from 313 to 350 per 100,000 (11%) for the at-risk population. By 2029, a combined average projection forecast the annual number of hip fractures at 10,311, with an incidence rate of 463 per 100,000, representing a 32% increase from 2021. Based upon these projections, assuming discharge rates remain constant, the total overall length of hospital stay following hip fracture in Scotland will increase by 60,699 days per annum, incurring an additional cost of at least £25 million per year. Approximately five more acute hip fracture beds may be required per hospital to accommodate this increased activity. Conclusion Projection modelling demonstrates that hip fracture burden and incidence will increase substantially by 2029, driven by an ageing population, with substantial implications for health and social care services.
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Affiliation(s)
- Euan Harris
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Nick Clement
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Alasdair MacLullich
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Luke Farrow
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
- Grampian Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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